Tuesday, 16 June 2015

Gliflozins. A 'new' drug for Diabetes

Gliflozins, SGLT2 inhibitors, have not been around very long. They are a new class of drugs developed for the treatment of type 2 diabetes. The first of these, Canaflifozin was approved by the FDA (US drug regulator) in 2013. Other types are called Dapafloflozin and Empagliflozin. They seek to prevent glucose getting into the blood stream.Like all conventional drugs, gliflozins will have been fully tested by the drug companies. The tests will have confirmed, to the satisfaction of drug regulators that they are effective and safe. The full rigour of science will have been used to ensure that patients are not harmed.Like all new drugs, the drug companies will have marketed it by telling us about its magnificent potential, as in this Times of India article. "With the introduction of ... the Gliflozins, a new era of therapy has been ushered in, whereby independent of the insulin mechanism, the diabetic just flushes out the extra glucose in the urine. The efficacy of these drugs is significant and can lead substantial benefit in controlling the spiraling sugars in the diabetic. Simultaneously , the excreted glucose carries away un wanted calories and over a period of time results in some favorable weight loss".

So we have "a new era", a drug whose "efficacy is significant", and "can lead to substantial benefit in controlling the spiralling sugars in the diabetic". The patient can even expect to lose weight.

So can we look forward to the diabetes epidemic to be reduced? Has medical science has triumphed, yet again? Can patients benefit greatly from the new wisdom of conventional medicine, and the brilliance of the pharmaceutical industry? Or are Big Pharma promises destined, once more, to hit the dust?

This is the headline of the GP magazine, Pulse (16th June 2015). Within two years of the launch of these game-changing drugs, problems have been identified - despite 'rigorous' scientific testing - despite the work of drug regulators.

"The European Medicines Agency (EMA) said it was conducting the review after 101 cases of diabetic ketoacidosis - a condition usually seen in patients with type 1 diabetes - were reported worldwide in patients with type 2 diabetes using the drugs to help control their blood glucose.

"All the cases were serious and some required patients to be admitted to hospital, the EMA said, while some patients’ blood glucose levels were not elevated as is usually characteristic of the condition, potentially delaying diagnosis and treatment.

"The regulator said it was writing to GPs and other clinicians about the risk of diabetic ketoacidosis and how to manage it and that ‘patients who have any concerns about their diabetes medicines should consult their doctor or pharmacist’.

It is the usual story with conventional medical drugs.

The early hype of a safe and effective new drug.

It is given to patients, then quickly realised that it harms patients in ways that science did not predict.

The review will almost inevitably deduce that there are problems, but the advantages outweigh the disadvantages.

Doctors will continue prescribing the drug to patients, and more harm and damage will be done.

More reviews will be undertaken, but for many years it is unlikely that effective action will be taken to protect patients.

And although doctors will be asked to use caution, patients will not be told about the dangers of the drug.

The medicine offered to us by the conventional medical establishment is usually unsafe, and often dangerous. Patients need to know this before they accept any drug or vaccine. Unfortunately, largely owing to the weakness of our media, most patients do not know. And so our doctors continue to harm us with drugs like Gliflozins.